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Archived: Next Stage 'A way Forward' North East Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 20 March 2018

This was an unannounced inspection carried out on 28 November 2017.

This was the first inspection of Next Stage A Way Forward North East since it was registered with the Care Quality Commission in March 2017.

Next Stage a Way Forward is registered to provide personal care. The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities using the service can live as ordinary a life as any citizen. People using the service lived in their own flat. A separate office was also available on-site to manage the supported living arrangements and there was a staff presence over twenty four hours.

A separate office off-site was registered to provide the domiciliary service. The service also provides care and support to people living in a ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living, this inspection looked at people’s personal care and support.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This related to safe care and treatment, staff training and governance.

People told us they felt safe and were well cared for. However, systems were not in place to keep people safe and to provide consistent care to people. Strategies were not in place to support distressed behaviours effectively. Risk was not well-managed. There were sufficient staff to meet the allocated care provision of people.

Improvements were required to staff training and the safe handling of medicines to ensure people received safe and effective care.

People were encouraged to follow a healthy and nutritional diet. Although staff were caring an understanding of professional boundaries was not in place for all staff. People’s privacy and dignity were respected. People were able to make choices about aspects of their daily lives. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

People were supported to be part of the local community. Improvements were needed to the social aspects of people’s lives to support them to lead more fulfilled lives with the provision of a range of opportunities to follow new interests and hobbies and the encouragement of work or college placements.

People had some opportunities to give their views about the service. There was regular consultation with people. People had access to an advocate if required.

A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to.

Staff and people who used the service told us the registered manager was supportive and approachable. People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. Improvements had been made to communication within the service.

A robust quality assurance system was not in place to assess the quality of the service. Audits that were required were not all carried out and some that were carried out were not effective as they had not identified issues that we found at inspection.

You can see what action we told the provide

Inspection areas

Safe

Requires improvement

Updated 20 March 2018

Not all aspects of the service were safe.

Risks to people were not always well-managed. Systems were not all in place for the management of distressed behaviours.

Improvements had been made to the management of medicines.

There were sufficient staff employed to meet people�s needs.

Effective

Requires improvement

Updated 20 March 2018

The service was not always effective.

Staff were not all appropriately trained to meet the needs of people who used the service.

People received care they agreed to. Where people did not have capacity to consent to their care, the service protected their rights under the Mental Capacity Act 2005.

People were assisted in meeting their dietary requirements.

Arrangements were in place to request support from health and social care services to help keep people well. External professionals� advice was sought when needed.

Caring

Requires improvement

Updated 20 March 2018

Not all aspects of the service were caring.

Staff knew people�s care and support needs and backgrounds and personalities to help deliver care to the individual. However, not all staff were aware of professional boundaries when supporting people.

Staff spent time interacting with people and they were encouraged and supported to be involved in daily decision making.

People were supported to maintain contact with their friends and relatives.

Staff supported people to access an advocate if the person had no family involvement.

Responsive

Requires improvement

Updated 20 March 2018

The service was not always responsive.

Records were in place with a system of regular evaluation and review to provide guidance to staff about people�s care and support needs.

People were supported to contribute and be part of the local community. Structured individual plans needed to be put in place that captured people's interests and aspirations so individual social care plans were developed.

People had information to help them complain. Complaints and any action taken were recorded.

Well-led

Requires improvement

Updated 20 March 2018

The service was not always well-led.

A registered manager was in place who was registered with the CQC.

Staff and people told us the management team were supportive and could be approached for advice and information.

A quality assurance system was in place, but checks were not being carried out with external scrutiny by the provider, to check the effectiveness of service provision and to ensure systems were in place to provide safe and effective care to people who used the service.